Examination Process
This examination, comprised of both a written and oral component, tests whether candidates have demonstrated the competencies necessary to be able to develop, implement and monitor evidence-based therapeutic plans and have the relevant knowledge to use the substances and medications allowed by the specific provincial jurisdictions.
The examination consists of two parts – an oral assessment and a written exam, both of which must be passed by achieving a score of at least 60%. Both components of the exam are conducted on the same day and take approximately five hours.
ORAL ASSESSMENT
This is a one-on-one oral assessment exam. Participants will be given a 1-2-page case, which will include background information, a brief description of the patient’s chief concerns, the diagnosis, the current drug therapy, and pertinent lab values. Participants will be given 25 minutes per case to develop a prescribing plan, which includes writing a prescription and a follow-up evaluation of the patient. Participants will be given all 3 cases when they begin the oral exam and have 75 min of preparation time where they will have access to written references as needed. After the preparation time, participants will meet with an oral assessor for approximately 20 min/case to discuss:
- the goals of therapy
- five treatment options (including advantages and disadvantages of each treatment option)
- the treatment plan (with details regarding why that plan was chosen, how therapy will be implemented and if any drugs need to be stopped)
- monitoring parameters for efficacy and safety
- any additional aspects of the case the naturopathic doctor wants to address
- the outcome of the assessment will be pass or fail. Participants who fail can be provided with the reasons for the fail on request.
Here is a rough breakdown of the mark allocation for the oral exam
Goals of therapy: 5 marks
Treatment: 10 marks
Selection of treatment (and justification) with drug and dose and implementation: 8-12 marks (depending on complexity of case)
Monitoring parameters: 10 marks
Additional suggestions for the case: 5 – 10 marks (depending on case)
Other Potential/Optional Marks:
CVD risk calculation and benefit of therapies: 2-5 marks
PICO: 4 marks
COMMON REASONS FOR FAILURE OR MARKS BEING DEDUCTED ON THE ORAL EXAM
- Recommending a drug to which the patient has a significant allergy or intolerance
- Recommending a drug that has an important interaction with other concomitant therapies the patient is receiving
- Recommending a dose that significantly exceeds the usual or maximum recommended dose without a compelling reason to use a high dose
- Not treating a potentially serious condition
- Not stopping a medication that could be making the patient’s symptoms worse
WRITTEN EXAM
This is an open book, multiple-choice and short answer examination. The exam will consist of approximately 100 multiple choice questions and 10 practice prescription short answer questions. Participants will have a maximum of 2.5 hours (150 min) to complete the exam. The outcome of the assessment will be pass or fail.
PRACTICE WRITTEN EXAM QUESTIONS (These questions were posted Sept 2015 – they contain some new and revised questions – for exam purposes either this document or the previous one are fine to use)
OVERALL
Participants will be required to successfully complete both the oral and written portions of the assessment. Information on what disease states are covered on the oral and written exams can be found by reviewing the course spreadsheet document.